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Addiction and how it manifests has long been discussed and debated. Unfortunately, for most of history, that discussion put the onus of addiction on the individual. We now know that is no longer the case.
Within the recovery industry, the disease model is now widely regarded as the standard for how we understand addiction. This is also true here at Painted Desert Recovery, though it does still have some detractors. Ultimately, the concept of the disease model of addiction is relatively straightforward.
The disease model of addiction centers around the idea that addiction is a progressive chronic “disease” rather than a personal choice. It posits that there are biological changes that occur in the brain once addiction starts to manifest. These changes interrupt an individual’s ability to both resist drinking or using substances and stop once they have started. In recovery circles, this is often stated as “One drink or drug is too many, and a thousand is never enough.”
The “chronic” aspect of the disease model of addiction primarily has to do with the progressive nature of addiction. A helpful way to think of addiction is to liken it to other progressive diseases like cancer, heart disease, or diabetes. Without some form of professional intervention or treatment, these diseases will almost always get worse, never better. Now, the same is true with addiction.
The chronic nature of the disease also refers to how addiction hits certain biological stages with no turning back. This does not mean that one cannot recover from addiction, far from it. It does mean, however, that certain biological changes that occur in the disease model do not make it safe for an individual to drink or use even after a long period of sobriety. A conversational saying in recovery regarding this phenomenon is, “You cannot turn a pickle back into a cucumber.”
The disease model of addiction is not just a matter of determinism versus free will. It also takes biology into account.
According to the New England Journal of Medicine, “Advances in neurobiology have begun to clarify the mechanisms underlying the profound disruptions in decision-making ability and emotional balance displayed by persons with drug addiction. These advances also provide insight into the ways in which fundamental biological processes, when disrupted, can alter voluntary behavioral control…” Addiction-caused biological changes also follow a strict order of stages.
As per the New England Journal of Medicine, the following are the three stages of addiction.
This is the stage in which the individual begins their drinking or using, and the disease model of addiction starts to kick in. It is where dopamine starts to be released in the brain, which triggers the “reward center.” This is what keeps an individual active in their addiction. However, over time, this dopamine release reduces and then stops altogether.
This is the stage of the disease model where the individual no longer receives rewarding levels of dopamine, so they become agitated and prone to negative emotions. It is also where the “alcohol or drug-seeking behavior” kicks in because they are chasing previous feelings of euphoria.
This is the stage of addiction where the individual can no longer focus on anything other than getting that next drink or a drug. It is often why people lose interest in activities that they once ardently enjoyed. This is also where the impulsivity of the disease interrupts a person’s ability to say no to a drink or a drug.
The disease model of addiction also focuses on the genetic aspect of the disease. While it is not the only factor, it is now widely agreed upon that genetics play a role in an individual’s susceptibility to addiction.
According to the journal Clinical Pharmacology and Therapeutics, “Addictions are moderately to highly heritable. Family, adoption, and twin studies reveal that an individual’s risk tends to be proportional to the degree of genetic relationship to an addicted relative.” The reality is that knowing one’s family history can be highly beneficial when it comes to one’s addiction vulnerability.
Of course, there are some critiques of the disease model of addiction. The primary one is that addiction remains a “choice.” This puts the onus on individual willpower, which becomes hard to explain when an individual continues drinking or using in the face of losing everything.
The other critique has to do with “powerlessness.” These people believe that telling people they have a disease reduces their willingness to do something about it. It is the apathy argument that one cannot do anything about it anyway, so why even try? Some might say it’s a very defeatist critique.
Ultimately, the disease model of addiction has the most scientific support. The renowned astronomer and author Carl Sagan once said, “It is far better to grasp the universe as it really is than to persist in delusion, however satisfying and reassuring.”
Addiction is a progressive disease, not a personal choice. While addiction studies are continually changing and advancing, the disease model is currently the standard-bearer for how we treat and manage addiction in the recovery industry. Ultimately, here at Painted Desert Recovery, we agree that it is the best template we have to overcome addiction, live a life that is happy, joyous, and free, and learn to love ourselves again.
Most professionals and recovery communities now agree that the disease model is the best model for both understanding and treating addiction. It also helps to eliminate the stigma surrounding addiction. For more information about how to recover from addiction, please reach out to Painted Desert Recovery today at (844) 540-0353.